Hyperhidrosis: a management dilemma.

Hyperhidrosis is excessive sweating in response to psychological stress and emotional stimuli. The sweat is usually limited to the palms, soles, and axillae, and is greatly accentuated by mental stimuli rather than temperature and exercise. The severity is such that for many, sweating has become socially and emotionally devastating and may predispose to other cutaneous diseases. More than 60 research papers on eccrine glands and sweating have been published since 1978. Little progress, however, has been made on the control of hyperhidrosis, and the process remains a treatment dilemma among both family physicians and dermatologists. The many treatment modalities documented in the literature have been for the most part unsuccessful or unacceptable. This report describes the use of phenoxybenzamine, an alpha-adrenergic antagonist, for control of excessive sweating in two patients. After a trial of topical medication, phenoxybenzamine is useful for the reduction of sweating to an acceptable level.